Tercan Us

Optimum Detection Times for Bacteria and Yeast Species with the BACTEC 9120 Aerobic Blood Culture System: Evaluation for a 5-Year Period in a Turkish University Hospital

ABSTRACT We tracked and documented the time of positivity of blood cultures by using the BACTEC 9120 (Becton Dickinson Diagnostic Instrument Systems) blood culture system over a 5-year study period. A 7-day protocol of the incubation period was selected, and a total of 11,156 blood cultures were evaluated. The clinically significant microorganisms (32.95%) were isolated in 3,676 specimens. Gram-positive and -negative bacterial isolation rates were found to be 41.07 and 44.88%, respectively. Yeasts were found in 14.03% of all pathogens. Both the false-positivity and -negativity rates were very low (0.1 and 0.3%, respectively). The mean detection times for all of the pathogens were determined to be 19.45 h. Yeasts, nonfermentative gram-negative bacteria, and Brucella melitensis strains were isolated within 5 days. By taking these data into account, we decided to establish a 5-day-incubation protocol in our laboratory instead of the 7 days that are commonly used.

Cigarette Smoking Increases Plasma Concentrations of Vascular Cell Adhesion Molecule-1 in Patients with Coronary Artery Disease

Cigarette smoking adversely affects endothelial function and increases risk of coronary artery disease (CAD). The pathogenesis of coronary atherosclerosis is currently thought to involve interactions between inflammatory cells and vascular endothelium. Adhesion molecules play a pivotal role in the accumulation of inflammatory cells at the endothelium. Little is known about the role of cigarette smoking in this atherosclerotic inflammatory process. The aim of this study was to evaluate the effects of cigarette smoking on the plasma concentrations of soluble vascular cell adhesion molecule-1 (VCAM-1) in patients with CAD. The soluble VCAM-1 level was quantified in smoking CAD patients (n=19) in comparison to those from patients with CAD alone (n=10). Plasma concentrations of soluble VCAM-1 were measured by enzyme-linked immunosorbent assay. The soluble VCAM-1 level was found significantly higher in smokers than in nonsmokers (32.1279 ±21.6421 vs 9.4570 ±7.8138 ng/mL, p<0.01), and in patients with previous myocardial infarction (MI) than in those without previous MI, but not significant statistically (27.7279 ±22.8813 vs 17.8170 ±15.9172 ng/mL, p>0.05). No significant difference was observed for soluble VCAM-1 levels between hypertensive and nonhypertensive patients, multivessel and one-vessel disease, or anterior and inferior MI localizations. The present study suggests that in patients with CAD, smoking leads to elevated levels of soluble VCAM-1 that may clarify one of the mechanisms of its accelerating effect on the atherosclerotic process.

The investigation of parvovirus B19 infection in patients with haematological disorders by using PCR and ELISA techniques

Parvovirus B19 has a marked tropism for erythroid progenitor cells. This may lead to chronic anemia in predisposed individuals. The purpose of the study was to investigate the frequency of parvovirus B19 infections in patients with diagnosis of haematological disorders. In order to determine the diagnostic use of different markers of parvovirus B19 infection, serum specimens obtained from 79 patients with haematological disorders were tested for specific antibodies and viral DNA through the use of ELISA and PCR techniques. Evidence of parvovirus B19 infection was found in 23/79 (29.1%) patients by demonstrating viral DNA and/or specific IgM antibody. B19 infection was established in 3 of 11 patients with chronic myeloid leukemia, in 3 of 11 acute myeloid leukemia, in 2 of 11 patients with multiple myeloma, in 3 of 8 patients with Hodgkins lymphoma, in 5 of 10 patients with non-Hodgkins lymphoma, in 1 of 6 patients with myelodysplastic syndrome, in 4 of 11 patients with chronic lymphocytic leukemia, and in 2 of 11 patients with acute lymphocytic leukemia. In 4 of 23 positive patients, only parvovirus B19 DNA could be detected, while 7 patients were tested positive for both parvovirus B19 DNA and specific IgM. Nine patients were tested positive for both B19 DNA and specific IgG. In the remaining 3 positive patients only specific IgM could be detected. Due to the discrepancies between DNA and IgM results, the diagnostic procedures should include a search for specific DNA by PCR methods if specific IgM has been found to be negative.

Immune response after a single vaccination against 2009 influenza A H1N1 in hemodialysis patients

Background: Influenza infection is a significant cause of morbidity and mortality in general population. Hemodialysis patients are considered at high risk of influenza infection given their altered immune status. Pandemic influenza virus is new for human beings, so it is hard to predict the response to infection or vaccination. We aimed to evaluate the response to pandemic H1N1 vaccination in hemodialysis patients. Methods: A total of 70 patients on chronic hemodialysis and 20 controls who had been vaccinated against the pandemic influenza virus 5 weeks before the time of blood sampling were included into this study. The anti-H1N1 immunoglobulin G (IgG) antibodies of the patients were studied with enzyme immune assay (EIA) method. Our cut-off optical density (OD) value was 1.503. If the patients OD value was equal or higher than this value, it was considered as positive. If it was lower, it was considered as negative. Results: The mean OD value was 2.22 ± 0.42 in the patient group and 1.99 ± 0.34 in the control group (p < 0.05). Two of 70 patients and 1 of the controls had negative OD values and they were considered as nonresponsive to vaccination. There was also a negative correlation between the age and OD values in the patient group (r = −0.277, p < 0.05). Conclusion: H1N1 vaccine can be performed safely and cost effectively with a single dose to the risk groups especially to the hemodialysis patients. Evaluation of H1N1 IgG antibody with enzyme-linked immunosorbent assay (ELISA) may be a safe, easy, and cost-effective assay.

Adrenal insufficiency associated with cytomegalovirus infection in two infants

Adrenal insufficiency associated with cytomegalovirus (CMV) is a well-described condition in adults with AIDS, however there is little information about CMV-associated adrenal insufficiency in childhood. The cases of two infants with negative HIV serology, presenting with CMV-associated adrenal insufficiency, are described. Clinical findings and therapeutic interventions are discussed with reference to the affinity of CMV infection for the adrenal gland. The differential diagnosis of adrenal insufficiency in newborns and infants should include CMV infection, and clinical suspicion of CMV-associated adrenal insufficiency should lead to early initiation of appropriate adrenal substitution therapy and ganciclovir antiviral therapy. Timely therapy for CMV-associated adrenal insufficiency can be lifesaving.

HPV DNA and Pap smear test results in cases with and without cervical pathology

OBJECTIVE The aim of the study was to determine the HPV prevalance and its relation to Pap smear, colposcopy and colposcopy directed biopsy in our region of Eskisehir, Turkey. MATERIAL AND METHODS A total of 615 women who applied to the outpatient clinic between December 2009 and December 2010 constituted our study population. All patients underwent pelvic examination and Pap smear sampling. Patients who had pathological cervical appearance or Pap smear results of ASCUS, AGUS, LSIL or HSIL were referred to colposcopy. Cervical samples for HPV DNA were taken from the patients before Pap smear sampling during the routine examination or before the colposcopic evaluation. RESULTS Twenty six of 615 patients (4%) were HPV positive. Of these 26 patients, 12 were positive for HPV type 16, 3 for type 18, 3 for type 51, 2 for type 6, 1 for type 52, 1 for type 33, 1 for type 16 and type 31, 1 for type 6 and 52, 1 for type 56 and 90, 1 for type 39 and 66. In 4 patients with cervical cancer, and in 3 of 4 CIN III cases both HPV DNA and Pap smear were positive. In the Pap smear examination of 615 patients, cytology revealed 35 ASCUS (5.6%) 4 AGUS (0.6%), 2 CIN I (0.3%) results who were negative for HPV DNA. These patients with abnormal cytology (n=41) underwent colposcopy directed biopsy, there were 3 CIN I and 1 CIN III and all the other cervical biopsy results of these patients were benign (inflammation, chronic cervicitis). CONCLUSION HPV positivity in our hospital setting is low which is compatible with other studies in Turkey. In positive HPV cases there is a good correlation between HPV type and positive cervical biopsy results.

Comparison of Methods Used For The Diagnosis of Epstein-Barr Virus Infections in Children

The accurate diagnosis of Epstein-Barr virus (EBV) infections is important, as many other infectious agents or diseases can cause similar symptoms. In this study, sera of pediatric patients who were suspected to have an EBV infection, were sent to Eskisehir Osmangazi University Faculty of Medicine, Department of Clinical Microbiology, and investigated by IFA, ELISA, immunoblotting and Real-time PCR. The performances of these tests were compared with IFA. The rates of agreement between ELISA and IFA were found as 100% for seronegative, 100% for acute primary infection, 22.2% for late primary infection, 92.1% for past infection. The rates of agreement between immunoblotting and IFA were found as 80.8% for seronegative, 68.8% for acute primary infection, 55.6% for late primary infection, 86.6% for past infection. The sensitivity of immunoblotting for anti-VCA IgM was identical with ELISA, and higher for anti-VCA IgG, anti-EBNA IgG, anti-EA antibodies, while the specificity of immunoblotting for these antibodies were found to be lower. The sensitivity and specificity of Real-time PCR for detection of viremia in acute primary infection were found as 56.25% (9/16) and 97.89% (139/142), respectively. The diagnostic methods should be chosen by evaluating the demographic characteristics of patients and laboratory conditions together.

The frequency of occult HBV infection in Eskisehir region of Turkey between 2001 and 2015

DOI: 10.4328/JCAM.5023 Received: 14.04.2017 Accepted: 17.05.2017 Printed: 01.12.2017 J Clin Anal Med 2017;8(suppl 4): 296-9 Corresponding Author: Müge Aslan, Department of Microbiology, Eskisehir Osmangazi University, Faculty of medicine, Eskisehir, Turkey. T.: +9